Center for Psychological and Forensic Services

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8492 Issued in FL

Legal business name

CENTER FOR PSYCHOLOGICAL AND FORENSIC SERVICES

Practice address

6801 Lake Worth Rd
Suite 122
Greenacres, FL 33467-2955

Phone

(561) 318-5340

NPI assigned

Feb 20, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kathy Rosalie Nicholls, PSY.D.NPI 1952651606

Title

President/Clinical Director

Phone

(561) 370-4469

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathy Rosalie Nicholls, PSY.D.

  • Psychologist
  • Lake Worth, FL
  • NPI 1952651606
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424390400000",
    "number": "1659763191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD",
            "address_2": "SUITE 122",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672955",
            "telephone_number": "561-318-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD",
            "address_2": "SUITE 122",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672955",
            "telephone_number": "561-318-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PSYCHOLOGICAL AND FORENSIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A",
        "authorized_official_last_name": "NICHOLLS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "ROSALIE",
        "authorized_official_title_or_position": "PRESIDENT/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "561-370-4469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Greenacres, FL
• Providers in Greenacres, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.